When Heart Patients Discharge Themselves, Hospital Bills Increase

Study found their care cost more if and when they were readmitted

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THURSDAY, May 20, 2010 (HealthDay News) -- Hospital patients receiving treatment for heart disease who decide to discharge themselves before their doctors deem them ready end up costing hospitals more if and when they are readmitted.

The finding, set to be reported this week during the International Society for Pharmacoeconomics and Outcomes Research meeting in Atlanta, comes from work conducted by researchers at the University of Maryland school of Pharmacy (UM).

The UM team, led by Eberechukwu Onukwugha, an assistant professor in the school's department of pharmaceutical health services research, analyzed the records of more than 347,000 heart patients who had been cared for at Maryland hospitals between 2000 and 2005.

Nearly 20,000 of those patients had been readmitted to the same hospital for more heart care following their initial stay.

The authors found that self-discharged patients ended up costing hospitals upwards of 9 percent more in treatment expenses than doctor-discharged patients.

Motivations for self-discharge against medical advice include a range of patient considerations, including the need to take care of children, concern about employment, needing to pick up a paycheck, wanting to see their own physician, or being made to wait for a long time to see medical personnel. For those with a history of substance abuse, needing to get a fix was another reason to leave prematurely.

But in the end, those who left against medical advice were more likely to come back in the short run, Onukwugha noted in a news release.